Let’s get something out of the way first. I’m not going to talk about firefighters. Firefighters define heroism in the popular imagination. Especially after the terrorist attacks of September 11, 2001, the fireman is a condensed symbol of personal sacrifice, courage, expertise, tenacity, and total devotion to a cause. And because there were no front line soldiers to celebrate after that disaster, anyone wrapping himself in the bloody flag made sure to pop on the FDNY hat as well.

Professional firefighters are neither the most endangered nor the most selfless of people in America. They are well-equipped, well-trained, and well-paid. “Firefighter” is not in the top ten most dangerous jobs. It’s way worse to be a farmer, a cab driver, or a fisherman. Firefighters do dangerous things every day for excellent pay in the best possible circumstances.

So what distinguishes firefighters from other people who are paid well to take risks? The difference lies in the character of their employer, the fire department.

No city or town can exist without a fire department. As industrial cities grew, city-consuming fires became a threat to public order and commerce. If you can barely see your neighbor’s stove smoke, your house fire is your problem. If you’re in a cluttered row of shops in London, a fire three doors down grabs your interest right away. Private fire departments on a subscription basis didn’t quite do the trick, for obvious reasons. If half the town burned but your store didn’t, there wasn’t much to celebrate.

So, inevitably, firefighting services were expanded to include more and more places. If the whole city’s resources could be thrown at one nasty fire, it wouldn’t consume everything else. Stopping the destruction was far better than insuring against it. Like public health, the fire department was accepted as necessary, compulsory, and authoritative. Nobody could opt out of paying for the fire department, or object to their regulations, because it would endanger everyone else.

Fire departments themselves looked beyond municipal boundaries. When big disasters happen, sometimes they overwhelm one city’s resources. Other nearby departments have agreed to mutual aid, so that any fire department will help any other fire department in these circumstances. Today these arrangements are large and sophisticated enough that departments will send their resources a thousand miles away if a serious incident requires it.

The fire departments also took on the job of medical rescue. It made sense that the first to respond to fires and other disasters knew how to care for the injured, and this progressed to the point that fire departments had medics as well as people who just put out fires. Today every town has medics in their fire department, who work with private ambulances and hospitals. If someone is ill or injured, those medics will respond right away and help, and then figure out what can be done further.

I’m sorry to bore you with all of that detail, but there’s a point to this. The universal presence of these fire departments represents a commitment by the people in each town. The commitment is this:

If there is any fire, natural disaster, or other physical threat to life and property in this city, we are willing to pay a large sum of money to make sure that the problem is fixed as quickly as possible, without regard for who owns the property involved or why it happened. If any of our neighboring cities is overwhelmed by such an incident, we are willing to send as much of our own as we can to help. We will never go back on this, because the city and its neighbors are interdependent and we’ll all go up in flames if we don’t keep our promises.

Furthermore, if anyone is injured or becomes ill in our city, whether it’s a resident or not, we are willing to pay a large sum of money to see that this person receives the best in immediate treatment and transportation to a hospital. We’ll never go back on this, because we are committed to the health and safety of our own residents, and without the good hospitality of offering this to everyone, we can’t offer it to anyone. We trust that other cities will treat our residents likewise.

This is quite a statement. This means that if anything catches fire or falls over or floods anywhere in town, it’s our problem, we got it. And if anyone falls on the sidewalk or overdoses or gets food poisoning or tries to commit suicide here, that’s our problem too, we’ll take care of it. Always. And we know you’ll do it for us.

On Tuesday, August 15, 2006 at 1:53 PM, eleven Companies of Los Angeles Firefighters, three LAFD Rescue Ambulances, two LAFD Helicopters, one LAFD Swift Water Rescue Team, two LAFD Dive Teams, one LAFD Rehab Unit, one LAFD Hazardous Materials Squad, one EMS Battalion Captain, one Battalion Chief Officer Command Team, one Division Chief Officer Command Team and Los Angeles Police Department resources, including the LAPD Underwater Dive Unit, under the Unified Command of Los Angeles Police and Fire Department Command Officers, responded to a Water Rescue and Recovery Effort near 1555 North San Fernando Road in the Los Angeles community of Glassell Park.

In this case, some teenagers were messing around fishing in a flood control channel and one of them fell in. The city sent what must be tens of millions of dollars in equipment and more than a hundred people, all moving as fast as possible including by air and water, to save one person who screwed up. No one asked if he was from Los Angeles, or even if he was from the United States. No one asked if he’d paid up his fire and rescue subscription. The city, in the form of a huge commitment of resources, said “No problem. We got that.”

There’s a big fight in America right now about health care. It’s actually a fight about money, of course. Currently the economics of health are hilariously broken, and there’s a war of ideas on what to do about it. Some want very much for the public to provide care for those otherwise without, and other people resist the idea of paying with their own tax money for people they disapprove of, or dislike, or fear.

For those of you who don’t want to pay tax to support the medical bills of others: I invite you to consider the fire department. It’s terribly expensive. There’s a lot of waste. There’s corruption. And worst of all, they take our tax dollars and spend it on any idiot or loser who falls asleep smoking or does a y’all-watch-this stunt or texts while driving. They even spend our money saving whorehouses, dive bars, criminals, illegal immigrants, and people who’ve taken a vow to kill us all. .

And you wouldn’t have it any other way, because if the fire department isn’t for all of us, it just won’t work. There’s no time to check green cards or get out the big book of moral ideas and decide whether this conflagration or severed artery meets our local standard. There is only time to help, or not.

So whether this influences your view on the current health care debate or not, I hope you will take the time to ask yourself: which town do you want to live in? The one who says “Yeah, we got that, no problem”? Or one that can’t figure out whether you’re worth their trouble in time to save you?

The first few paras feel like an unnecessary digression. I suspect the argument is actually stronger if you leave mostly implicit the admiration we all feel for firefighters. Cynical of me to say this, perhaps, but downplaying the risk of their occupation is an oblique lead-in that leaves me feeling uncertain about whether you actually like firefighters. You could make the same point about how we resource them, for example, by leading with ‘nothing’s too good for our valiant firefighters’.

I sincerely hope this gives pause to those who consider only the US’ pre-eminence in quality of available health and ignore its abysmally poor delivery of said service.

The first few paragraphs are there because in other discussions about this the conversation was derailed by arguments about the meaning of firefighter heroism from one side or another. In a less ridiculous world none of that would need to be said.

You’re right that extended care and crisis intervention are different problems. The consequences of denying medical coverage to everyone are not exactly those of denying fire and rescue. Since both inevitably end in stacks of corpses and public health disasters I felt comfortable eliding that point.

I guess I was suggesting that there might be a rhetorical approach that would allow you to more or less assume that ground was covered, à la ‘Firefighters are awesome; let’s look at what makes them so awesome.’ But you’re a better judge of the audience than I could hope to be.

I think you’re right, by the way, to leave long-term care issues alone, as they’re not germane to the concept of universal access.

Yes, I deliberately left out volunteer firefighters, despite knowing a few personally. A township or county with volunteer firefighters only isn’t any less committed to the ideas above. They just have less money.

There are fewer volunteer departments every year. I liked the sticker I saw on one part-time fire truck: MY TRUCK, MY GAS, TO SAVE YOUR ASS.

I wonder if libertarians are in favor of decriminalizing child pornography? Aren’t those laws an unconscionable interference in the free market? Won’t “natural market forces” cause child porn to wither up and die on its own?

good job with the criminalization– since then, child porn has all but disappeared! and sick people get the help they need!

OH WAIT. the state puts the few sickos it catches together in prisons, it doesn’t reform anyone, it lets them out with little to look forward to, and then it forces them to group together geographically (try drawing 1000 ft circles around every park, school, etc. and see what’s left).

and now our children are being labeled Sex Offenders by the state for taking photos of THEIR OWN BODIES.

there are problems that aren’t solved by free markets, that are ALSO NOT SOLVED by governments, no matter how totalitarian they get.

I like to bring up the military whenever anyone drags out the “the government can’t even run a post office!” argument (not to mention that the post office will send you crap all over the world for pennies or dollars…) or “do you want the doctor’s office to be like the DMV?” There is an entrenchment of idolization about the military that seems to be a nice conservative oriented debunker.

How can I listen to any politician or former politician who espouses a hatred of government when they themselves willingly participated in it?

More seriously, government is a necessary evil. The idea that a modern country with automatic weapons and 300 million people needs *less* government boggles my mind. Perhaps libertarians have a lot more faith in the morality of their fellow men than I.

There are other government programs that anti-government types use all the time. The USPS, Medicare/Medicaid and the Interstate Highway System all come to mind. Then the are the copious “background” services that we all benefit from, a short list of which would include: USPTO, CDC, Coast Guard, FBI, CIA, FDA, FAA.

Those that deify the military (and I’d like to out myself as a war nerd) as the only thing the government does right probably never served. The armed forces are a bureaucratic nightmare, as nearly any veteran will tell you. The Pentagon is the worst example of profligate spender in D.C. (or Virginia). This isn’t just my opinion but Sect. Gate’s too.

In (1) times of peace the military is almost totally a waste. In (2) times of War the military becomes an absolute necessity. BTW, by “Time of War” I mean a real and actual attack on the country not one of Bush’s Wars. By necessity to be prepared for (2), (1) is required.

As for military medical, I think it is pretty good. Even the VA, which is not part of the military.

I do not think that the military is a waste in peace time. It is useful in domestic disasters and engineering efforts — and, of course, as a deterrent against foreign aggression. The US used to disband most of the army after wars and that robbed it of the institutional knowledge of veterans (particularly snipers).

And I’m glad to hear someone speaking in favor of the VA. You hear a lot of horror stories these days, but the VA has helped a lot of vets.

I know a lot of vets that have been helped by the VA and have taken a few back and forth to appointments. I have heard horror stories but you hear those about a;; medical services. I would guess that I know fairly well 100 people that have been treated extensively by the VA and none of them have expressed anything negative.

Do you think the state should interfere with your neighbor watching your child, because they aren’t properly licensed?

(Both of these are government intrusions that happen today.)

Whom do you trust more, Consumer Reports or the FDA? The same FDA whose “food pyramid” is STILL a lie, paid for by big-agriculture.

> Perhaps libertarians have a lot more faith in the morality of their fellow men than I.

To want small government is to *recognize* that man has the capacity for evil, and that giving enormous power to a few people is a really bad idea. I suspect that you believe that government helps the little guy. How you can still believe that in these days of rampant trillion dollar thefts is beyond me. But I don’t blame you. You’re the victim of the same propaganda that the rest of us are.

They have taught us very well to fear ourselves, to fear each other, to fear fear fear. And only they can save us! And they will only require most of our productive labor to do it. (If you balk at the word “most” here, you need to look beyond the income tax, to the thousands of other taxes, and know that they *all* end up, eventually, being payed by the final consumer of the goods.)

That you include the CIA in your “helpful services” list demonstrates that you don’t really know what is going on in this world.

If any of the other services you list are really desired by the people who currently pay for them (tax payers, or anyone who holds dollars [via inflation]), people would find other ways to get them done. Is that not obvious? “Oh, poor stupid people, can’t accomplish anything without big brother.”

If you want to be treated like a child your whole life, that’s fine, hire someone to tell you what you can and cannot do, who you can deal with, what plants you are allowed to have. But please don’t support the ruling elite in doing that to the rest of us.

To want small government is to *recognize* that man has the capacity for evil, and that giving enormous power to a few people is a really bad idea.

To want small government is to hide from the complexities modern urban life engenders. Without a healthy government, crime rules in its place as we see in modern Russia today. But I do agree that power corrupts. The only hedge against that corruption is a healthy democracy. Whether that’s what obtains in the US is a matter of debate.

Two quick examples of what people can do without government. In 1982, former president Carter created the non-governmental Carter Center, which successful combated hideous diseases like Guinea Worm and river blindness in African nations. The second example is Bernie Madoff who predated on insular Jewish communities to defraud them of billions of dollars.

So I do not deny that people can accomplish a lot without the government.

What I’m suggesting is government can do and does good things all the time. Do bureaucracies do evil? Of course they do. However, public bureaucracies have a level of accountability that private ones do not. And make no mistake, we need bureaucracies. That’s how Stuff Gets Done in modern (even medieval) life.

But I don’t blame you. You’re the victim of the same propaganda that the rest of us are.

You know, I too was once greatly enamored with conspiracy theories. I’ve read Howard Zinn and Noam Chomsky. I continue to see the barrel of US foreign and domestic policy for what it is. But I also realized that while there are indeed many small conspiracies out there, most of what we see can be explained by the forces of entropy: greed and stupidity. Neither markets nor morality will protect us from each other. We need rules of engagement enforced by a third party. At its best, that’s what the government does.

I suppose in this context, I come off quite the fascist. But then, what you suggest comes off as anarchy.

The point I was actually trying to make is that you, a supposedly free person, cannot trade with me, a supposedly free person, for *whatever* service and for *whatever* compensation we consensually agree upon.

Do you really think that another human being, squeezed out of their mother just like all the rest of us, somehow has the authority to tell you and me we can’t interact however we choose to?

I see no reason to give up personal freedom for the “service” of protection from scary businesses. Not when there are other proven ways to achieve the same protection: see Ebay’s reputation system or Consumer Reports.

(There’s another argument to be made, that government licensing isn’t actually about safety, but rather about intentionally limiting market competition to favor the entrenched business interests, such as limiting the quantity of taxi medallions in a given city, but let’s leave that for another time.)

> However, public bureaucracies have a level of accountability that private ones do not.

My guess here is that a) you believe democracy works and that b) you see the rampant corporate crime and attribute that to the non-government side of the equation.

If democracy works, why do the wars never end? The people don’t want them. It takes massive scare tactics to bring a populace on board with any war. Remember when Obama was the anti-war candidate? Does democracy actually work if we elect him, then the wars continue? And actually expand? How exactly do you propose we stop these people from murdering innocents all over the world?

I mean red team was clearly horrible. Then we switched to blue team, and it’s still horrible. What now?

As for the whole “Government Good / Corporations Bad” idea, one thing we don’t learn in government schools is that corporations are a product of government.

But is that not clear? For starters, they are nothing but a file folder in a government office. A promise of government protection (legal and physical) for a cut of the action (taxes).

But beyond that, find me a big scary corporation that does not receive a huge amount of their income, legal protection, often military services, from government. Big corporations grow up with government. (This is historically true, as well, eg. http://en.wikipedia.org/wiki/East_India_Company )

We can’t boycott Haliburton or Blackwater. But what would they do if the federal government disappeared? Either they would find a way to attract legitimate business or they would cease to exist as a business.

And you know what? No one seems to want hyper-violence when they’re spending their own money. ;) I dare you to find one historical case of an individual spending their own money on a war. Has it happened once, ever?

> You know, I too was once greatly enamored with conspiracy theories.

I’m not sure what you’re referring to. When I said propaganda I was referring to the pro-government education, pro-government media, and the pro-government culture it creates.

How hard is it to believe that an education system run by X, receiving all of its budget from X, somehow fails to reveal ugly truths about X?

> But then, what you suggest comes off as anarchy.

Anarchy, meaning lack of rulers, has been redefined by those who currently rule us as “chaos.” How convenient for them. ;)

(When I refer to those who currently rule, I do not mean the few elected officials. If they held the real power, the US would not have had a consistent foreign policy of war and empire building for the past 70 years.)

Gore Vidal once said something whose exact wording I wish I
could recall, but the gist of it was: There don’tneed to be conspiracies- everyone running the placealready thinks the same way, so it’s not as if they
need to go circulating memos in invisible ink.

* * *

You can get much of the function, if not form, of
conspiratorial information exchange by simply having the same
dizzy Right People running into eachother at the same
restaurants and exchanging a few confused nouns (of meaningstotally oblivious to them, but playing along) that
will make full sense only to their assistance: “Hm, Tblisi,
those airlines, ooff and the banks”. Then an assistant
kicks it down the chain of command until it hits someone who’s
super-ambitious and will go do whatever.

* * *

I once saw a PBS show on “superspy” Robert Hanssen, who wassuper-jazzed that he got to go to some exclusive Opus
Dei meetings and hear Father Magno-Sekreto say guaranteed
amazing things that the average man isn’t privy to and can’t
possibly understand with even 100% of his brain! And
Hanssen brought a friend, a confidant, to whom he could show
off the awesomeness of this Opus Dei meeting.

And the PBS show interviewed that friend— who might
actually have been the guy trying to catch Hanssen. And
the guy said: it was crap. No “but our strategy for
converting souls in southern Egypt, against the threat of
Islam, is…”. No, it was just crap, blather, a
Dissociated Press algorithm run on a corpus of Vatican memos
that themselves weren’t about anything in particular.
Not even the sheer weirdness and pyrotechnics of Scientology,
or the Saint Germain loonies, or the occasional Buck Rogers
architecture of the Freemasons, or the… nonexistence of the
Rosicrucians. No, just crap. And Hanssen was just
giddy from it, just ’cause “TEE-HEE WE’RE IN A CONSPIRACY!”

I figure that if there are conspiracies, that at least half
of them are practically irrelevant, because they’re likethat. Plus there’s lunatics inside who are trying to
rob and embezzle entire hundreds of dollars!, and there’s also aimless political
infighting, but to no real end except who gets the bigger
office and the bluer Secret Stapler Of Power.

Apparently if you just go around saying “we have secrets
and we are hard to get at”, and people will beat down your
door, and if there’s nothing inside, they will be in yet
greater awe! And the you can try: “Guys, no, it was just a
joke we were pulling on you, there’s really nothing here, the
whole thing is… nothing!” but all you’ll get back
is “You’re saying that only because you have things to
hide!“

So this is how far we, as a global civilization, have
fallen: we can’t even have decent conspiracies. Everyone
involved ends up being lazy, stupid, crazy, or petty.
It’s like a state university English department.

* * *

Oh, but if you wanna read about a really fucked up
and scary conspiracy, even type of conspiracy,
read Sterling’s Heavy Weather.

Iggy, this is a amazingly insightful comment. It sums up the inherent problem with the way the war on terror has been prosecuted for the last eight years. The US army still has a third generation warfare strategy. Insurgencies are implicitly fourth generational.

We cannot “win” in Iraq or Afghanistan with the military precisely because of this impedance mismatch. We our army takes ground, the insurgents retreat to fight another day. You might as well try to empty the sea with a sieve.

I know that our politics aren’t always the same, but the points of agreement far outweigh the area of disagreement.

A bunch of my friends on here are your friends on here, so I saw two links to this. I’m glad I did. It’s fantastic.

So the next question is: why do people (except the most trying-to-make-a-point libertarians) feel fine about fire departments and not health care? Is it just how these things have been framed for them by politicians and talking heads? Is it an unspoken assumption that fires are accidents but sickness is somehow a sign of some failing? And if it is, where does that come from and what the hell can be done about it?

Because as much as I agree with you, it’s important not to think of people who oppose universal healthcare as just plain wrong through some inherent conservative smallness of spirit. I mean, I do, but I am trying not to. It’s better to be able to engage with it.

Um hi I don’t know you and maybe this is presumptuously much commentary from a stranger.

Some people object to socialized medicine or anything near it on purely ideological grounds. They believe that a freer market in health care would be preferable to more government interference. I disagree, but they do have one good point: there never was anything like a free market in health care, so you can’t just blame commerce for the mess. If we could choose our health care personally based on price and quality, the people profiting from the status quo would be just as sad as they would under socialized medicine.

Unfortunately most of the people I encounter in person or in the media are doing a good impression of the “smallness of spirit” you refer to. Demagogic talk radio does a fine job of spreading FUD and poking at the fear and resentment people have about their precarious lives. I don’t think those people are evil, but they’re badly misinformed. And I am angry at them for being childishly selfish in a situation that demands adulthood and a (very small) amount of personal sacrifice.

Finally, you’re right about the attitude towards the sick and injured. That’s just built into to us. Shun the wounded animal, avoid the infected. Hospitals were nearly prisons for most of Western history. If you’ve seen how a crowd treats a person in a wheelchair, it’s easier to understand why people don’t want to pay each others’ hospital bills. Identifying with someone who is ill is psychologically very expensive.